title: Determinants of vascular function in patients with chronic gout.
abstract: Epidemiologic studies have proposed a relationship between hyperuricemia and cardiovascular (CV) risk. However, it is unclear whether uric acid (UA) is an independent risk factor for CV disease (CVD) after controlling for other predisposing conditions. Gout patients might have persistent systemic inflammation, which, in addition to hyperuricemia, may potentiate CVD. This study examined vascular function and markers of CV damage in gout patients when compared with healthy controls. Brachial artery flow-mediated dilatation, arterial compliance, and microvascular function were measured. Circulating apoptotic endothelial cells and endothelial progenitor cells were quantified by FACS and circulating biomarkers of CVD by enzyme-linked immunosorbent assay. Gout patients displayed significant increases in body mass index, C-reactive protein, UA, and triglycerides and decreases in high-density lipoprotein. There were no significant differences in other CV traditional risk factors, adhesion molecules, or chemokines. Gout patients did not differ from controls in vascular function. In univariate and multivariate analysis, UA was not associated with the quantified CV risk parameters. Despite an increase in several CV risk factors, inflammation, and UA, gout patients display normal endothelial function and no increases in biomarkers of CVD. These results do not support the notion that gout is an independent risk factor for premature CVD.
authors.affiliation: Divisions of Rheumatology and Cardiology, Department of Internal Medicine; the Michigan Institute for Clinical Research, University of Michigan Medical School, 1150 W. Medical Center Drive, Ann Arbor, MI 48109, USA.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Brook
authors.forename: Srilakshmi
authors.initials: S
authors.lastname: Yalavarthi
authors.forename: James D
authors.initials: JD
authors.lastname: Myles
authors.forename: Shokoufeh
authors.initials: S
authors.lastname: Khalatbari
authors.forename: Rita
authors.initials: R
authors.lastname: Hench
authors.forename: Susan
authors.initials: S
authors.lastname: Lustig
authors.forename: Wendy
authors.initials: W
authors.lastname: Marder
authors.forename: Adam
authors.initials: A
authors.lastname: Neidert
authors.forename: Mariana J
authors.initials: MJ
authors.lastname: Kaplan
mesh_terms: D000328:Adult; D017209:Apoptosis; D015415:Biomarkers; D002319:Cardiovascular System / Q000473:pathology*; D016022:Case-Control Studies; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D004730:Endothelium, Vascular; D005260:Female; D006073:Gout / Q000150:complications* / Q000473:pathology; D006305:Health Status Indicators; D006801:Humans; D033461:Hyperuricemia / Q000150:complications* / Q000473:pathology; D008297:Male; D055806:Microvessels; D008875:Middle Aged; D015999:Multivariate Analysis; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
chemical_list: D015415:Biomarkers